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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 125. This is the beginning of the thread.
Posted by joe schmoe on June 29, 2011, at 12:03:56
I have recently gotten into beer tasting as a hobby and noticed a curious thing. Some days beers taste delicious, and other days the exact same beers taste horribly bitter. This puzzled me for a long time until now, when I found this study
"Serotonin-specific reuptake inhibitors (SSRI) blunt bitter taste acutely (minutes), but enhance it chronically (hours) in normal healthy humans."
Apparently SSRIs in the study decreased the bitterness taste threshold by 53% (!). If I am reading this correctly, it means things taste twice as bitter as they should.
Since I sometimes skip a dose of celexa, or take half a dose, or take it at different times of the day (it has a 35 hour half life so I don't pay close attention to when I take it) it could explain why sometimes, beer is tasty and other times, it is horribly bitter.
I am tempted to start some hourly taste experiments with a bitter food (dark chocolate) to see how my sense of taste varies throughout the day based on when and at what dosage I take the celexa.
Anyone else ever have experience with ssris making food more bitter? Ever experiment regarding the best time to take the ssri to reduce this effect? Or is skipping a dose the only way to get a normal sense of taste?
Just read Viibryd is coming out nationwide on Friday, which happens to be when my next appointment is with my pdoc, so hopefully I will be moving on to that drug - although I suspect it will have the same bitterness taste issues.
Posted by Phillipa on June 29, 2011, at 13:15:28
In reply to SSRIs and sense of taste (bitterness), posted by joe schmoe on June 29, 2011, at 12:03:56
I just know I lost my taste and smell 8 years ago and eat dark chocolate nightly to try and taste at least a little bit. I take such low doses of ssri's don't think it's that they the docs said virus or the antibiotics took for chronic lymes. Phillipa
Posted by joe schmoe on June 29, 2011, at 13:33:35
In reply to Re: SSRIs and sense of taste (bitterness) » joe schmoe, posted by Phillipa on June 29, 2011, at 13:15:28
> I just know I lost my taste and smell 8 years ago and eat dark chocolate nightly to try and taste at least a little bit. I take such low doses of ssri's don't think it's that they the docs said virus or the antibiotics took for chronic lymes. Phillipa
As an aside, I took a serious hit to my sense of taste after using Listerine Total Care (the fluoride rinse one with the purple color). Burned my tongue and only many months later after stopping using it am I getting my full sense of taste back. So if you are using any mouthwashes, try stopping them for at least three months and see if it helps.
Also a lot of people sued Zicam after they lost their sense of smell after using the inhaled gel form of it, and got a settlement from the company. I used to use it for colds but stopped after I read about that.
Posted by jms600 on June 29, 2011, at 17:46:54
In reply to SSRIs and sense of taste (bitterness), posted by joe schmoe on June 29, 2011, at 12:03:56
That's quite interesting. I've been on most SSRIs in the past and never noticed any taste disturbances. Like you I also enjoy trying different ales.
I found that zopiclone does give me a bitter taste in my mouth, while promazine (in syrup form) tends to dull my taste buds and make my tongue numb.
I wonder if taking the Celexa just before you go to bed each night would make a difference?
Posted by joe schmoe on June 29, 2011, at 19:41:16
In reply to Re: SSRIs and sense of taste (bitterness), posted by jms600 on June 29, 2011, at 17:46:54
I intend to experiment with taking it at different times and strengths to see the difference, although if I do get the Viibryd on Friday, I intend to switch to that. Of course, it might cause the same effects, since the effect occurs in the tongue, not the brain apparently, and Viibryd is an SSRI.
For tasting experiments I bought some ultra-dark chocolate (which I cannot stand) so I can try little pieces of it throughout the day to see how its bitterness is affected as the time increases from my last celexa dose. I have never liked bitter foods (coffee, dark chocolate, grapefruit, etc.) but there is no doubt the celexa has made this much worse, on a varying daily basis. Liking a beer one night and finding it horribly bitter the next has been a very strange experience.
Posted by Phillipa on June 29, 2011, at 22:09:02
In reply to Re: SSRIs and sense of taste (bitterness), posted by joe schmoe on June 29, 2011, at 19:41:16
Loss of taste and smell starts with smell as that means you can't taste. The taste buds arent implicated in this as the sense salty, sweet, bitter, and spicy. Hold your nose and try to taste. Seems on my googling many meds do either cause loss of taste or taste perversion which is what I feel you may have? Phillipa
Posted by morgan miller on June 29, 2011, at 23:47:47
In reply to SSRIs and sense of taste (bitterness), posted by joe schmoe on June 29, 2011, at 12:03:56
I've never really experienced this, if anything, my tolerance for bitter foods is greater on an SSRI-currently combining sertraline and escitalopram. I believe that this happens though, just not the case with me, at least I have not been acutely aware of it if it has. Beer always tasted good on SSRIs. Maybe, maybe, my tase for bitterness was more sensitive when I was just on escitalopram(lexapro).
Posted by joe schmoe on June 30, 2011, at 12:08:47
In reply to Re: SSRIs and sense of taste (bitterness), posted by morgan miller on June 29, 2011, at 23:47:47
I just tried the dark chocolate again. Yesterday (28 hours or so since the last celexa) it was absolutely vile. Today (42 hours since I took a celexa) while not good (I don't like dark chocolate and this is 86% cacao, the bitterest stuff I could find) it does not taste poisonously bitter like it did yesterday, it just doesn't taste good. Especially noticeable is the lack of a horrible bitter aftertaste it had yesterday.
A little later I will have to try some beers and see the difference.
Posted by joe schmoe on July 3, 2011, at 15:47:30
In reply to Re: SSRIs and sense of taste (bitterness), posted by joe schmoe on June 30, 2011, at 12:08:47
Well I am on my third day of Viibryd. Pdoc gave me a month starter pack, you titrate up on 10 mg for a week, then 20 mg for a week, then you are at full dose of 40 mg for two weeks (and presumably from then on).
For reference, Tuesday I took my normal 20mg of Celexa, Wednesday I skipped it as part of the bitterness taste test, Thursday I took 10 mg of Celexa, and Friday I started the Viibryd. Today is Sunday (for those reading this in the future). Celexa half-life is 35 hours, Viibryd is 25 hours if I recall correctly.
Not particularly activating or sedating at this point. I should mention I also take clonazepam so that could be affecting my perception of how activating it is. I have been taking it in the morning. You have to take it with food.
Some weird feelings (slight dizziness, mild brain zaps when turning my head, etc.) that I have experienced in the past when discontinuing Celexa. I suspect that due to the titration up, my overall levels of serotonin are lower which could be causing these symptoms. Nothing too bothersome (at least so far) and I think it is due to the celexa discontinuation, I doubt someone starting clean would experience this.
Sense of taste is remarkably improved, both dark chocolate and beer are noticeably less bitter and taste much better. I don't know if this will last once I get to the higher Viibryd dosage, could just be because serotonin levels are lower right now during the switch.
Sexual sensitivity seems to be returning although it has varied in the past even on Celexa for no apparent reason so I am not drawing any conclusions yet. Again it could be due just to low serotonin levels and not the Viibryd at this point.
Posted by joe schmoe on July 6, 2011, at 21:12:33
In reply to Day 3 of Viibryd, posted by joe schmoe on July 3, 2011, at 15:47:30
So far this feels very much like a straight Celexa withdrawal. Fatigue, can't get a full night's sleep, and lot of napping or attempted napping. When I stand up or move around (or look around) I get dizzy.
Had an episode last night of feeling hot, sweating and a racing heartrate/fast pulse for about an hour. Both are symptoms of serotonin syndrome, but fortunately they went away.
I'm curious what Viibryd feels like to someone starting it "clean." For most people I suspect it will be like it is for me: as much about stopping the previous antidepressant as it is about starting Viibryd.
I bought some more dark chocolate because it actually tastes pretty good, unlike a week ago. I am using it as a taste test, since I am curious whether my perception of bitterness will increase as the Viibryd dose goes up the way it increased while on Celexa.
Posted by bearfan on July 6, 2011, at 22:14:41
In reply to Day 6 of Viibryd, posted by joe schmoe on July 6, 2011, at 21:12:33
I've also started Viibryd. So far if I'm not really impressed. It's somewhat sedating, but not overly so. Have not been super social or feel much more in the way of motivation (although this could be the depression). Reminds me of Lexapro (not overly sedating or activating). I would like to give it at least 2-3 weeks before re-evaluating.
Posted by joe schmoe on July 7, 2011, at 21:45:36
In reply to Day 7 of Viibryd, posted by bearfan on July 6, 2011, at 22:14:41
Well, I am on Day 7.
Tried a couple of beers tonight, a Scotch Ale and a Milk Stout. Both are relatively sweet beers (the former due to caramelized malts, the latter due to the addition of lactose, a non-fermentable sugar, to the beer) yet they both tasted somewhat bitter to me and not sweet.
I wonder if this means my serotonin levels are rising again towards Celexa levels. Not much point in drinking beer if it tastes like this.
Still feeling very dizzy and strange when I am standing up and walking around. Going to the food store was not particularly pleasant. I still blame this on Celexa withdrawal though, since I have experienced the same thing before when stopping Celexa.
Posted by Phillipa on July 7, 2011, at 21:48:13
In reply to Re: Day 7 of Viibryd, posted by joe schmoe on July 7, 2011, at 21:45:36
Brain zaps the tiniest piece of a second where you turn your head or eyes and feel dizzy? Phillipa
Posted by joe schmoe on July 8, 2011, at 0:11:38
In reply to Re: Day 7 of Viibryd » joe schmoe, posted by Phillipa on July 7, 2011, at 21:48:13
> Brain zaps the tiniest piece of a second where you turn your head or eyes and feel dizzy? Phillipa
Well, "dizzy" is putting it lightly. More like "altered state of reality" often accompanied by a tingling sensation or worse.
I seem to have a harder time than most coming off Celexa. The effects can last for months for me. I am kind of surprised that the Viibryd is not preventing it. I guess the dosages are not comparable.
Posted by bearfan on July 8, 2011, at 0:40:46
In reply to Re: Day 7 of Viibryd, posted by joe schmoe on July 8, 2011, at 0:11:38
My experience with Lexapro/Celexa withdrawals haven't been that hard to deal with. I did have quite a bit of trouble with Paxil and Effexor however. There is some dizziness accompanied by Viibryd, which might be associated with some of the Serotonin agonist activity much in the same way in how Buspar has. Unfortunately, Viibryd hasn't been on of those drugs that 'kicks in' fast. I've been on it for a little more than a week and haven't been really impressed with ability to make me more proactive in social environments or make me more motivated. There is however, a noticeable anxiolytic effect, which I hope continues. As far a side effects, there are some spaciness, laziness, dizziness and tiredness that are noticeable, and slight digestive issues (although not as bad as some other SSRIs). I want to try to give it at least 3-4 weeks, before deciding to go back to something stronger.
Posted by joe schmoe on July 8, 2011, at 2:07:07
In reply to Re: Day 7 of Viibryd, posted by bearfan on July 8, 2011, at 0:40:46
Well yeah, the first week you are only at 10 mg, the second 20 mg, you don't even start the recommended final dose till the third week (40 mg) so if you are using a starter pack like me, I definitely wouldn't judge it for a month or more at least.
Posted by Phillipa on July 8, 2011, at 19:52:53
In reply to Re: Day 7 of Viibryd, posted by joe schmoe on July 8, 2011, at 2:07:07
Comes in a starter pack? Any reason why I wonder? Phillipa
Posted by joe schmoe on July 8, 2011, at 23:31:25
In reply to Re: Day 7 of Viibryd » joe schmoe, posted by Phillipa on July 8, 2011, at 19:52:53
> Comes in a starter pack? Any reason why I wonder? Phillipa
Probably because of the three different dosages you use when titrating up, or whatever it's called when you increase dosage over time.
Posted by joe schmoe on July 9, 2011, at 15:07:09
In reply to Re: Day 7 of Viibryd, posted by joe schmoe on July 8, 2011, at 23:31:25
Well, I don't want to get too graphic, but the sexual side of things is definitely improving in every way.
Had "morning wood" for the first time I can remember in years!
Posted by Phillipa on July 9, 2011, at 19:16:36
In reply to Day 9 of Viibryd, posted by joe schmoe on July 9, 2011, at 15:07:09
I guess that's good!!! Phillipa
Posted by sigismund on July 10, 2011, at 2:18:59
In reply to Re: Day 9 of Viibryd » joe schmoe, posted by Phillipa on July 9, 2011, at 19:16:36
>I guess that's good!!!
It most certainly is, and suggests to me as well that you had some deep sleep.
Posted by joe schmoe on July 10, 2011, at 12:39:25
In reply to Re: Day 9 of Viibryd, posted by sigismund on July 10, 2011, at 2:18:59
I am pretty convinced at this point that the dizziness/spaceyness I have been feeling lately when standing up is not purely Celexa withdrawal, it is due to the Viibryd. There is no doubt that I feel much more dizzy as the day and evening go on (I have been taking Viibryd with breakfast, which for me is around noon). So I am going to switch to taking it shortly before bed (always with food) and see how that goes.
Hopefully the dizziness is just a temporary effect of getting used to the drug. In any case taking it at night should help.
I should mention I have had a few instances of restless leg syndrome while waking up from a nap in my easy chair. I have had this before from time to time over the years, so it is nothing alarming, especially since it only lasted a few minutes (I think it happened twice in the past ten days). But it is a weird enough sensation (if you've never experienced it, I can't convey what it's like) that I want to note it before I forget. Hasn't happened in bed at night, fortunately.
Posted by mtdewcmu on July 10, 2011, at 15:49:32
In reply to Day 10 of Viibryd, posted by joe schmoe on July 10, 2011, at 12:39:25
> I am pretty convinced at this point that the dizziness/spaceyness I have been feeling lately when standing up is not purely Celexa withdrawal, it is due to the Viibryd. There is no doubt that I feel much more dizzy as the day and evening go on (I have been taking Viibryd with breakfast, which for me is around noon). So I am going to switch to taking it shortly before bed (always with food) and see how that goes.
Part of Viibryd's effect is the same as Buspar. Buspar made me dizzy.
Posted by Lamdage on July 10, 2011, at 18:49:17
In reply to Re: Day 10 of Viibryd » joe schmoe, posted by mtdewcmu on July 10, 2011, at 15:49:32
Id like to see more new meds coming.. new maoi. how sweet would it be to have a nice variety
Posted by bearfan on July 10, 2011, at 18:55:19
In reply to Re: Day 10 of Viibryd, posted by Lamdage on July 10, 2011, at 18:49:17
There already is a new maoi in the works; it called tririma
No diet restrictions and as strong as the traditional ones. Its a strong Rima.
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